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South Dakota rates for HCPCS J9316

Injection, pertuzumab, trastuzumab, and hyaluronidase-zzxf, per 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.10 / $44,541.03 / $44,541.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.10 / $62.71 / $8,149.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.16 / $64.80 / $80.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.39 / $107.13 / $158.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.39 / $70.56 / $282.02
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.59 / $95.08 / $111.79
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.59 / $95.08 / $99.91
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.95 / $67.95 / $67.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.10 / $63.88 / $76.04
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.37 / $69.37 / $69.37
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.37 / $69.37 / $69.37